Methods and Devices for Improving Bone Healing

Abstract

A method for treating a bone defect extending between a proximal bone structure and a distal bone structure of a patient may include resecting a region of bone between the proximal bone structure and the distal bone structure and encompassing the bone defect, positioning a biodegradable osteogenic scaffold within a biodegradable sleeve, coupling the biodegradable sleeve to a fixation member, positioning the biodegradable sleeve between the proximal bone structure and the distal bone structure, and attaching the fixation member to each of the proximal bone structure and the distal bone structure.

1 . A method for treating a bone defect, the method comprising:
 positioning a biodegradable osteogenic scaffold within a passage defined by a biodegradable sleeve;   positioning the biodegradable sleeve along a first bone portion and a second bone portion such that the biodegradable osteogenic scaffold is disposed within the bone defect; and   coupling the biodegradable sleeve to each of the first bone portion and the second bone portion.   
     
     
         2 . The method of claim  21 , wherein coupling the biodegradable sleeve to the fixation member comprises sliding the biodegradable sleeve onto the fixation member. 
     
     
         3 . The method of  claim 1 , wherein positioning the biodegradable sleeve along a first bone portion and a second bone portion comprises:
 inserting a distal end portion of the first bone portion into a proximal end of the biodegradable sleeve such that the distal end portion contacts the biodegradable osteogenic scaffold; and   inserting a proximal end portion of the second bone portion into a distal end of the biodegradable sleeve such that the proximal end portion contacts the biodegradable osteogenic scaffold.   
     
     
         4 . The method of claim  21 , wherein coupling the biodegradable sleeve to each of the first bone portion and the second bone portion comprises:
 coupling the biodegradable sleeve to the first bone portion using a first plurality of screws; and   coupling the biodegradable sleeve to the second bone portion using a second plurality of screws.   
     
     
         5 . The method of  claim 1 , further comprising treating the biodegradable osteogenic scaffold with one or more bioactive agents to facilitate bone growth or angiogenesis.) 
     
     
         6 . The method of claim  21 , further comprising treating the biodegradable sleeve and the fixation member with an antibiotic to inhibit infection. 
     
     
         7 . The method of  claim 1 , further comprising:
 obtaining computed tomography scans of the patient; and   fabricating the biodegradable osteogenic scaffold and the biodegradable sleeve based at least in part on the computed tomography scans.   
     
     
         8 . The method of  claim 7 , further comprising resecting a region of bone between the first bone portion and the second bone portion and encompassing the bone defect, the method further comprising fabricating a cutting guide based at least in part on the computed tomography scans, wherein resecting the region of bone between the first bone portion and the second bone portion and encompassing the bone defect comprises resecting the region of bone using the cutting guide. 
     
     
         9 . The method of  claim 1 , wherein the biodegradable osteogenic scaffold is formed of a calcium phosphate-based material or a composite comprising a calcium phosphate and a polymer, and wherein the biodegradable sleeve is formed of polycaprolactone or a composite comprising a calcium phosphate and polycaprolactone. 
     
     
         10 . The method of claim  21 , further comprising detaching the fixation member from the first bone portion and the second bone portion and removing the fixation member from the patient after the bone defect has healed and the biodegradable osteogenic scaffold and the biodegradable sleeve have degraded. 
     
     
         11 . A device for treating a bone defect, the device comprising:
 a biodegradable sleeve configured for positioning along a first bone portion and a second bone portion;   a biodegradable osteogenic scaffold configured for positioning within a passage defined by the biodegradable sleeve; and   wherein the biodegradable sleeve is configured for coupling to each of the first bone portion and the second bone portion such that the biodegradable osteogenic scaffold is disposed within the bone defect.   
     
     
         12 . The device of claim  22 , wherein the passage defined by the biodegradable sleeve is a first passage extending from a proximal end to a distal end of the biodegradable sleeve and configured for receiving the biodegradable osteogenic scaffold therein, wherein the biodegradable sleeve further comprises:
 a second passage extending from the proximal end to the distal end of the biodegradable sleeve and configured for receiving a portion of the fixation member therein.   
     
     
         13 . The device of  claim 12 , wherein the biodegradable sleeve further comprises support ribs disposed between the first passage and the second passage and extending from the proximal end to the distal end of the biodegradable sleeve, and wherein the first passage is in communication with the second passage through a gap defined between the support ribs. 
     
     
         14 . The device of  claim 13 , wherein a portion of the biodegradable osteogenic scaffold extends into the gap when the biodegradable osteogenic scaffold is positioned within the biodegradable sleeve. 
     
     
         15 . The device of  claim 12 , wherein the first passage is further configured for receiving a distal end portion of the first bone portion and a proximal portion of the second bone portion therein. 
     
     
         16 . The device of  claim 12 , wherein the biodegradable sleeve further comprises a plurality of apertures disposed along one or more sides of the biodegradable sleeve and extending from an outer surface of the biodegradable sleeve to the first passage, and wherein the apertures are configured for controlling transcortical perfusion. 
     
     
         17 . The device of  claim 12 , wherein the biodegradable sleeve further comprises a plurality of openings disposed along a side of the biodegradable sleeve and extending from an outer surface of the biodegradable sleeve to the second passage, and wherein the openings expose respective portions of the fixation member when the fixation member is coupled to the biodegradable sleeve and are configured for receiving respective collagen sponges carrying an antibiotic therein. 
     
     
         18 . The device of  claim 12 , wherein the biodegradable osteogenic scaffold comprises a central passage extending from a proximal end to a distal end of the biodegradable osteogenic scaffold and configured for receiving a collagen sponge carrying rhB M P-2 or VEGF therein. 
     
     
         19 . The device of  claim 12 , wherein the fixation member comprises:
 a proximal portion configured for extending beyond the proximal end of the biodegradable sleeve when the fixation member is coupled to the biodegradable sleeve;   a distal portion configured for extending beyond the distal end of the biodegradable sleeve when the fixation member is coupled to the biodegradable sleeve; and   an intermediate portion configured for positioning within the second passage when the fixation member is coupled to the biodegradable sleeve.   
     
     
         20 . The device of  claim 11 , wherein the biodegradable osteogenic scaffold is formed of a calcium phosphate-based material or a composite comprising a calcium phosphate and a polymer, and wherein the biodegradable sleeve is formed of polycaprolactone or a composite comprising a calcium phosphate and polycaprolactone. 
     
     
         21 . The method of  claim 1 , further comprising coupling the biodegradable sleeve to a fixation member, wherein coupling the biodegradable sleeve to each of the first bone portion and the second bone portion comprises coupling the fixation member to each of the first bone portion and the second bone portion. 
     
     
         22 . The device of  claim 11 , further comprising a fixation member configured for coupling to the biodegradable sleeve, wherein the biodegradable sleeve is configured to be coupled to each of the first bone portion and the second bone portion by coupling the fixation member to each of the first bone portion and the second bone portion.